scholarly journals Association of fasting plasma glucose change trajectory and risk of hypertension: a retrospective cohort in China

2021 ◽  
Author(s):  
Yanmei Lou ◽  
Yanyan Zhang ◽  
Ping Zhao ◽  
Pei Qin ◽  
Changyi Wang ◽  
...  

To assess the association between fasting plasma glucose (FPG) change trajectory and incident hypertension among Chinese people, this cohort study included 11,791 adults aged 18 to 80 years without hypertension at first entry and who completed at least four follow-ups between 2009 and 2016. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between FPG change trajectory and probability of hypertension. During a median follow-up of 5.10 years (total person-years 61,887.76), hypertension developed in 2177 participants. After adjusting for baseline potential confounders, the probability of hypertension increased with the increasing FPG change trajectory (adjusted OR [aOR] 1.22, 95% CI 1.07-1.40), bell-shape trajectory (aOR 1.15, 95% CI 1.02-1.30) and other-shape trajectory (aOR 1.13, 95% CI 1.02-1.25) which showed a higher variability of FPG compared to the decreasing group. In addition, the increasing FPG change trajectory was associated with a higher probability of hypertension compared with the decreasing group regardless of age and body mass index (BMI) but was only significant in males and in those with normal FPG at baseline. Our study indicates that the increasing FPG change trajectory determines the highest risk of hypertension, demonstrating the importance of maintaining low and stable levels of FPG, especially in males and in those with normal FPG.

2021 ◽  
pp. 155982762110190
Author(s):  
Mandy K. Salmon ◽  
Neil F. Gordon ◽  
Demitri Constantinou ◽  
Kevin S. Reid ◽  
Brenda S. Wright ◽  
...  

Background. It is hypothesized that normal weight individuals develop diabetes through different pathophysiological mechanisms and that methods of prevention may differ in the absence of overweight/obesity. In this study, we compared the effect of lifestyle health coaching (LHC) on fasting plasma glucose (FPG) in normal weight, overweight, and obese US adults with prediabetes. Methods. Subjects were 1358 individuals who completed baseline and follow-up evaluations as part of an LHC program (follow-up = ~6 months). Participants were stratified, based on baseline body mass index (BMI), into normal weight (n = 129), overweight (n = 345), and obese (n = 884) cohorts. LHC included counseling, predominantly via telehealth, on exercise and nutrition. Results. BMI decreased ( P < .001) in the overweight and obese participants but was unchanged in the normal weight participants. FPG decreased ( P < .001) in all 3 cohorts, and the magnitude of decrease did not differ significantly among cohorts. FPG decreased to <5.6 mmol/L in 58.1%, 49.3%, and 41.4% of the normal weight, overweight, and obese participants, respectively. Conclusions. To our knowledge, this study is the first outside of Asia to show that LHC is as effective in managing FPG in normal weight adults with prediabetes versus those who are overweight/obese.


2019 ◽  
Vol 7 ◽  
pp. 205031211986039
Author(s):  
Eiichi Kakehi ◽  
Kazuhiko Kotani ◽  
Tadao Gotoh ◽  
Kazunori Kayaba ◽  
Shizukiyo Ishikawa

Objectives: The fasting plasma glucose/hemoglobin A1c ratio is considered a marker associated with glucose metabolism disorders, including fasting hyperglycemia. However, it remains unclear whether this ratio can be used for the prevention of deaths in individuals with normal fasting plasma glucose levels. This study aimed to see the predictive value of the fasting plasma glucose/hemoglobin A1c ratio for all-cause mortality in a general population with normal fasting plasma glucose levels. Methods: The study investigated prospectively a cohort of 1087 multi-regional, community-dwelling Japanese participants (women, 69.2%) for a follow-up period of 11.3 years. We included individuals with fasting plasma glucose levels <6.11 mmol/L and excluded those meeting the diabetes criteria. All-cause mortality was the primary outcome and hazard ratios were calculated using the Cox proportional hazard model after dividing the fasting plasma glucose/hemoglobin A1c ratios into tertiles. Results: There were 54 deaths (25 women) during the follow-up period. The high tertile group had a significantly higher hazard ratio for all-cause mortality than the low tertile group in women (multivariate-adjusted hazard ratio = 4.45; 95% confidence interval = 1.26–15.72), but not clearly in men. Conclusion: The data of the population-based cohort study suggest that a high fasting plasma glucose/hemoglobin A1c ratio can predict all-cause mortality in women with normal fasting plasma glucose levels.


BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e021768 ◽  
Author(s):  
Ying Chen ◽  
Xiao-Ping Zhang ◽  
Jie Yuan ◽  
Bo Cai ◽  
Xiao-Li Wang ◽  
...  

ObjectiveType 2 diabetes mellitus is increasing in young adults, and greater adiposity is considered a major risk factor. However, whether there is an association between obesity and diabetes and how this might be impacted by age is not clear. Therefore, we investigated the association between body mass index (BMI) and diabetes across a wide range of age groups (20–30, 30–40, 40–50, 50–60, 60–70 and ≥70 years old).DesignWe performed a retrospective cohort study using healthy screening programme data.SettingA total of 211 833 adult Chinese persons >20 years old across 32 sites and 11 cities in China (Shanghai, Beijing, Nanjing, Suzhou, Shenzhen, Changzhou, Chengdu, Guangzhou, Hefei, Wuhan, Nantong) were selected for the study; these persons were free of diabetes at baseline.Primary and secondary outcome measuresFasting plasma glucose levels were measured and information regarding the history of diabetes was collected at each visit. Diabetes was diagnosed as fasting plasma glucose ≥7.00 mmol/L and/or self-reported diabetes. Patients were censored at the date of diagnosis or the final visit, whichever came first.ResultsWith a median follow-up of 3.1 years, 4174 of the 211 833 participants developed diabetes, with an age-adjusted incidence rate of 7.35 per 1000 persons. The risk of incident diabetes increased proportionally with increasing baseline BMI values, with a 23% increased risk of incident diabetes with each kg/m2increase in BMI (95% CI 1.22 to 1.24). Across all age groups, there was a linear association between BMI and the risk of incident diabetes, although there was a stronger association between BMI and incident diabetes in the younger age groups (age×BMI interaction, p<0.0001).ConclusionsAn increased BMI is also independently associated with a higher risk of developing diabetes in young adults and the effects of BMI on incident diabetes were accentuated in younger adults.


2020 ◽  
Author(s):  
Xiaoli Li ◽  
Guilong Li ◽  
Tiantian Cheng ◽  
Jing Liu ◽  
Guangyao Song ◽  
...  

Abstract BackgroundTriglyceride-glucose index (TyG index) has been regarded as a reliable alternative marker of insulin resistance. However, study on the relationship between TyG index and incident diabetes remains limited. This study aimed to investigate the association between TyG index and incident diabetes in a large cohort of Chinese population.MethodsThe present study was a retrospective cohort study using healthy screening programme data in China. A total of 201,298 subjects free of baseline diabetes were included who received a health check with all medical records from 2010 to 2016. TyG index was calculated as Ln[fasting triglyceride level (mg/dl) x fasting plasma glucose (mg/dl)/2]. Diagnosis of diabetes was based on fasting plasma glucose ≥ 7.00 mmol/L and/or self-reported diabetes. Cox proportion-hazard model was used to assess the relationship between TyG index at baseline and the risk of incident diabetes. It should be noted that the data was uploaded to the DATADRYAD website, and we only used this data for secondary analysis.ResultsDuring a mean follow-up of 3.12 years of 201,298 individuals aged ≥ 20 years old, 3389 subjects developed diabetes. After adjusting for age, sex, body mass index, systolic blood pressure, diastolic blood pressure, total cholesterol, low density lipoprotein cholesterol, alanine aminotransferase, aspartate aminotransferase, serum creatinine, smoking, drinking and family history of diabetes, multivariate cox hazards regression analysis indicated that TyG index was positive correlation with the risk of developing diabetes in Chinese population (HR, 3.34; 95% CI, 3.11 to 3.60). The risk of incident diabetes increased with increasing TyG index. Subjects with TyG index in the fourth quartile were 6.26 times more likely to develop diabetes than the lowest quartile (P trend < 0.001). Subgroup analysis showed the stronger association was observed in the population with age < 40, BMI (≥ 18.5, < 24 kg/m2), SBP < 140 mmHg or females (all P for interaction < 0.0001).Conclusions TyG index was independently correlated with the increased risk of diabetes in Chinese adults, suggesting that TyG index may be a useful marker for identifying individuals at high risk of developing diabetes.


2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Xiaoli Li ◽  
Guilong Li ◽  
Tiantian Cheng ◽  
Jing Liu ◽  
Guangyao Song ◽  
...  

Abstract Background Recent studies have suggested the triglyceride-glucose index (TyG index) may serve as a suitable substitute for insulin resistance. However, evidence for the relationship between TyG index and risk of diabetes remains limited. This study sought to explore the association of baseline TyG index with risk of developing diabetes in Chinese adults. Methods This retrospective cohort study was conducted using data from the health screening program in China. A total of 201,298 non-diabetic individuals were included. TyG index was calculated as Ln [fasting plasma glucose (mg/dL) × fasting triglyceride level (mg/dL) / 2]. Diabetes was defined as fasting plasma glucose ≥126 mg/dL and/or self-reported diabetes. Cox proportion-hazard model was employed to evaluate the independent impact of baseline TyG index on future diabetes risk. Sensitivity and subgroup analyses were implemented to verify the reliability of results. Notably, data were downloaded from the DATADRYAD website, and used only for secondary analyses. Results During an average follow-up of 3.12 years, among 201,298 individuals aged ≥20 years, 3389 subjects developed diabetes. After adjusting for potential confounders, elevated TyG index were independently correlated with greater risk of incident diabetes (hazard ratio (HR), 3.34; 95% confidence interval (CI), 3.11–3.60). Compared with the lowest quartile (Q1), increasing TyG index (Q2, Q3, and Q4) was related to increased HR estimates of incident diabetes [HR (95% CI), 1.83 (1.49–2.26); 3.29 (2.70–4.01), and 6.26 (5.15–7.60), respectively]. Moreover, a nonlinear relationship was observed between TyG index and risk of diabetes and the slope of the curve increased accompanying the rise of TyG index. Subgroup analysis revealed the positive association was stronger among subjects with age < 40 years, body mass index ≥18.5 kg/m2 and < 24 kg/m2, or systolic blood pressure < 140 mmHg, or in females. Conclusions Elevated TyG index is independently correlated with increased risk of incident diabetes in Chinese adults, indicating it may represent a reliable predictor of diabetes in high-risk populations.


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